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CRNA vs. Anesthesiologist: What’s the Difference?

Rebecca Munday
Updated August 29, 2023
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Are you interested in anesthesiology, but you can’t decide between CRNA or anesthesiologist? Find out key differences between the two careers to help you decide.
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Both certified registered nurse anesthetists (CRNAs) and anesthesiologists have similar responsibilities but one of them approaches the responsibilities using a nursing background and the other uses a medical background. Learn more about the education, job outlook, salary, and practice authority of both these roles to help you decide which career path may be best for you.

Certified Registered Nurse Anesthetist and Anesthesiologist Key Similarities and Differences

Certified registered nurse anesthetists and anesthesiologists differ in educational background, salary, practice authority, and work setting. CRNAs have a nursing background while anesthesiologists have a medical background. Anesthesiologists report higher earnings, but CRNAs are in higher demand, according to the U.S. Bureau of Labor Statistics (BLS).

What Is a Certified Registered Nurse Anesthetist?

A CRNA works with physicians and surgeons to care for patients before, during, and after procedures that need anesthesia. They tend to work in rural hospitals, on routine cases, and outside of the operating room. They have a nursing background, a doctor of nursing practice degree (DNP), and CRNA national certification.

CRNAs may work with surgeons or physicians independently or they may work under the supervision of an anesthesiologist, depending on the practice authority in their state.

What Is an Anesthesiologist?

Anesthesiologists work with surgeons and physicians to care for patients before, during, and after procedures that need anesthesia. They tend to work with more complex cases, surgical cases, and in large hospital systems.

They attend medical school, complete four years of residency, and hold a medical degree (MD) or doctor of osteopathic medicine (DO) degree. Anesthesiologists supervise anesthesia assistants and CRNAs.

Anesthesiologists can practice independently and supervise CRNAs and anesthesia assistants anywhere they practice. CRNAs may only practice independently if their state allows full-practice authority and CRNA-only models. Otherwise, they practice under the supervision of an anesthesiologist.

Both CRNAs and anesthesiologists usually work in physicians’ offices, general medical and surgical hospitals, and outpatient care centers. CRNAs are more likely to work in the offices of other healthcare practitioners while anesthesiologists are more likely to work in higher education.

Despite their differences, CRNAs and anesthesiologists share similar responsibilities.

CRNA and Anesthesiologist Overview
Points to ConsiderCertified Registered Nurse AnesthetistAnesthesiologist
Degree RequiredDNPMD or DO
Certification OptionsCRNA National CertificationAmerican Board of Anesthesiology (ABA) Board Certification
Duties and Responsibilities
  • Provides obstetrics and pain management care
  • Monitor and report on patients’ vital signs
  • Collaborate with physicians
  • Take patients’ medical histories
  • Give local and general anesthesia and pain management
  • Assist with bedside airway management during codes or to manage difficult airway situations
  • Supervise CRNAs and anesthesia assistants
  • Handles more complex and specialized cases
  • Collaborate with physicians
  • Take patients’ medical histories
  • Give local and general anesthesia and pain management
  • Assist with bedside airway management during codes or to manage difficult airway situations
Average Annual Salary$202,470 (BLS, May 2021)$331,190 (BLS, May 2021)

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Duties and Responsibilities

CRNAs and anesthesiologists share many responsibilities. The main difference in responsibilities between CRNAs and anesthesiologists is that anesthesiologists supervise CRNAs and anesthesia assistants.

In 28 states, CRNAs must be supervised by an anesthesiologist so the care they provide will be reimbursed by the Center for Medicare and Medicaid Services (CMS). The remaining 22 states opted out of the facility reimbursement requirement and offer full-practice authority to CRNAs.

CRNAs and anesthesiologists share the same responsibilities in patient care. They both:

  • checkTake patient histories to make sure they can safely provide pain management and anesthesia
  • checkCollaborate with physicians
  • checkEducate patients about their treatment plan
  • checkAnswer patients’ questions about their treatment plan
  • checkGive local and general anesthesia
  • checkProvide pain management
  • checkDeliver emergency medical care
  • checkCare for patients before, during, and after surgery
  • checkMonitor and report on patients’ vital signs during and after procedures

However, anesthesiologists can supervise CRNAs and anesthesia assistants, which is a duty that not all CRNAs are allowed to perform.

Education and Certification

CRNAs complete about eight years of training; anesthesiologists complete 12 years. CRNAs attend nursing school, hold a DNP degree, and complete at least 1,000 hours of practicum. Anesthesiologists attend medical school, hold an MD or a DO degree, and complete four years of residency.

How to Become a Certified Registered Nurse Anesthetist

If you choose to become a CRNA, you will spend 7-8.5 years becoming a CRNA. Before entering a CRNA doctoral program, you will:

  • Earn your bachelor of science in nursing (BSN)
  • Pass the National Council Licensure for Registered Nurses (NCLEX-RN)
  • Get your RN license
  • Work full time in critical care for at least a year

Once you complete the necessary clinical requirements, you can enroll in a DNP program. Some DNP programs allow you to enroll with only a BSN and get your master of science in nursing (MSN) and DNP at the same time. Other DNP programs require you to have an MSN first.

After you complete your DNP degree, you can apply for CRNA National Certification Exam (NCE) from the National Board of Certification and Recertification for Nurse Anesthetists. To qualify for the NCE, you must have an unrestricted RN license and complete an accredited CRNA program within the last two years.

To apply for the NCE, you must submit:

  • A digital photo taken within the last six months
  • Your RN license number, issuing state, and expiration date for all states where you have an active RN license
  • An electronic record of your academic and clinical experience at an accredited program
  • An exam application that you’ve electronically signed

How to Become an Anesthesiologist

If you choose to become an anesthesiologist, you will spend 12 years completing a bachelor’s degree, medical degree, and anesthesiology residency. Each of these steps will take four years.

First, you will need to complete a bachelor’s degree and pass the Medical College Admission Test (MCAT). Then, you will spend four years in medical school. After medical school, you will complete a four-year residency in anesthesiology. You must complete at least one year of residency before you can sit for your licensure exam.

After you pass your licensing exam, you’ll become a licensed anesthesiologist. Then, you should consider becoming certified by the American Board of Anesthesiology. Certification is not required, but nearly 75% of anesthesiologists are certified according to The American Society of Anesthesiologists.

Certified Registered Nurse Anesthetist Education Requirements

  • Undergraduate degree: Four-year bachelor’s program
  • Entrance exam: NCLEX-RN
  • Graduate degree: DNP program (2-3 years)
  • Practicums: Hours vary by state
  • Licensure examination: CRNA National Certification Exam
  • Total time: 7-8 years

Doctor (MD or DO) Education Requirements

  • Undergraduate degree: Four-year bachelor’s program
  • Entrance exam: MCAT
  • Graduate degree: Four-year professional doctoral program (MD or DO)
  • Residency: 4 years
  • Specialty certification: American Board of Anesthesiology Board Certification (recommended)
  • Licensure examination: United States Medical Licensing Examination or Comprehensive Osteopathic Medical Licensure Examination
  • Total time: 12 years

Salary and Career Outlook

Anesthesiologists make about $129,000 more annually than CRNAs, but they can also have as much as $100,000 more in student loans by the time they finish residency. According to BLS data from May 2021, the job outlook for CRNAs is 11% higher between 2021-2031 than it is for anesthesiologists during the same 10 years.

Average Annual Certified Registered Nurse Anesthetist Salary

Source: BLS, May 2021

Average Annual Anesthesiologist Salary

Source: BLS, May 2021

Certified Registered Nurse Anesthetist Salary and Career Outlook

BLS data from May 2021 projects 12% job growth for CRNAs between 2021-2031, which is 7% higher than the average job growth for all occupations. CRNAs are especially needed in rural communities and hospitals because CRNAs save time, resources, and money.

CRNAs make up more than 80% of anesthesia providers in rural communities, according to the American Association of Nurse Anesthesiology in October 2022. Rural hospitals use a CRNA-only model for obstetrics care and pain management to save their patients long drives to seek physician care.

CRNAs earn an average annual salary of $202,410. They make an average of $97.34 an hour. CRNAs can earn more by changing their practice setting or location. According to BLS data from May 2021, the top three practice settings that offer CRNAs an average salary of more than $210,000 annually are:

  • Outpatient care centers
  • Specialty (except Psychiatric and Substance Abuse) Hospitals
  • General Medical and Surgical Hospitals

Two of the top five highest-paying states for CRNAs, Alaska and Wisconsin, offer CRNAs full-practice authority, and hold the four highest-paying metropolitan areas for CRNAs. All of those areas offer CRNAs an average of more than $208,000 annually.

Anesthesiologist Salary and Career Outlook

BLS data from May 2021 projects 1% job growth for anesthesiologists between 2021-2031. This growth that is 4% lower than average may be because more anesthesiologists are already employed than CRNAs, so the field doesn’t have as much room for growth.

Anesthesiologists make an average annual salary of $331,190, according to BLS data from May 2021. They make an average of $159.22 an hour. Anesthesiologists may earn more based on their practice setting, experience level, and skills.

Offices of physicians and outpatient care centers pay anesthesiologists the highest average salaries. According to Payscale data from November 2022, anesthesiologists may earn 10% more than average if they have 10 to 19 years of experience. Anesthesiologists who have more than 20 years of experience can earn 13% more than average.

Anesthesiologists may earn more if they have skills like:

  • Obstetrics anesthesia
  • Intensive care unit
  • Recovery or postanesthesia care unit

Certified Registered Nurse Anesthetist vs. Anesthesiologist: Which Career Is Right for Me?

Whether you should become a CRNA or an anesthesiologist comes down to your preferences about practice authority, salary, education requirements, career outlook, and types of patient you care for. You’ll have to consider which of these is most important to you in your career.

If you care more about earning a higher salary, working complex or specialized cases, and maintaining your independence anywhere you choose to practice, anesthesiologist may be the career choice for you. If you want to join a rapidly growing field sooner and with less debt, you may consider a career as a CRNA.

  • Education time line: CRNAs take between 7- 8.5 years to complete their education, including practicum experiences, but anesthesiologists take at least 12 years to complete their education and residency requirements.
  • Debt: CRNAs have about $100,000 less in student loan debt than anesthesiologists have by the time they finish their education and start practicing independently.
  • Salary: Anesthesiologists make about $129,000 more annually than CRNAs. This comes to $61.88 more an hour for anesthesiologists than CRNAs.

FAQ About Becoming a CRNA or an Anesthesiologist

Is CRNA school harder than med school?

The challenge of completing a DNP or medical degree will be unique to each individual and program. That said, only 6.5% percent of applicants are accepted into medical school, according to 2020 data from U.S. News and World Report. Medical education also takes longer to complete than CRNA school.

What can an anesthesiologist do that a CRNA cannot?

Anesthesiologists can work independently anywhere in the U.S., and they can supervise other members of the anesthesiology team. CRNAs can only practice independently in the Army, Navy, Air Force, Guam, and in the 22 full-practice authority states for CRNAs.

Is it better to be a CRNA or anesthesiologist?

The decision to pursue a career as a CRNA is not necessarily better than pursuing a career as an anesthesiologist. In fact, many of their responsibilities are the same. Which career is right for you depends on your expectations for your education time line, salary, job outlook, and practice authority.

Is CRNA a master’s or doctorate?

CRNAs need to earn a doctor of nursing practice degree. Visit our best CRNA degree programs page to learn more about CRNA programs and find the one that is right for you.

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Page last reviewed December 7, 2022

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